The Mask of Sanity

The Mask of Sanity: An Attempt to Clarify Some Issues About the So-Called Psychopathic Personality is a book written by American psychiatristHervey M. Cleckley, first published in 1941, describing Cleckley’s clinical interviews with patients in a locked institution. The text is considered to be a seminal work and the most influential clinical description of psychopathy in the twentieth century. The basic elements of psychopathy outlined by Cleckley are still relevant today.[1] The title refers to the normal “mask” that conceals the mental disorder of the psychopathic person in Cleckley’s conceptualization.[2]

Cleckley then summarizes the material and provides a ‘clinical profile’, describing 16 behavioral characteristics of a psychopath (reduced from 21 in the first edition): [15]

Some of the criteria have obvious psychodynamic implications, such as a lack of remorse, poor judgment, failure to learn from experience, pathological egocentricity, lack of capacity for love, a general poverty in major affective reactions, and lack of insight into his own condition.[2] Starting in 1972, newer editions of the book reflected a closer alliance with Kernberg‘s (1984) borderline level of personality organization, specifically defining the structural criteria of the psychopath’s identity integration, defensive operations and reality testing.[16]